The news: Healthcare startup Nolla Health will use AI to assess and diagnose mild-to-moderate acne and prescribe select topical medications in a Utah pilot, per Bloomberg, with physicians initially reviewing—but not writing—the prescriptions.

Nolla received clearance from the Utah Department of Commerce’s Office of Artificial Intelligence Policy to test AI-powered prescribing.

Here’s how it works: Through the Nolla Derm app, consumers verify their identity, complete a short health questionnaire, and take a five-angle face scan. The AI assesses acne severity, selects a treatment plan, and prescribes from eight topical medications, some of which are also available over the counter.

Human physicians provide oversight, but their review scales back over time as the program meets safety benchmarks.

• First 100 patients: 100% of AI-generated prescriptions get human review by two physicians before the prescription is issued.
• Up to 500 patients: 100% of prescriptions get human review but after the AI has sent them to the pharmacy.
• After 500 patients: Physicians review only a sample of at least 10% of prescriptions each month. All escalations and cases involving side effects are reviewed.

Nolla patients can also ask to meet with a human doctor at any time.

Why it matters: AI’s role in patient care is expanding and, in this case, taking over functions traditionally performed by a doctor.

Other health tech startups, including Doctronic and August AI, have piloted AI-powered prescription renewals for medications previously prescribed by clinicians with varying levels of physician oversight. Nolla goes a step further by using AI to assess patients’ skin, diagnose acne, select a treatment, and issue an initial prescription.

That will likely heighten concerns among medical experts. Even Doctronic’s renewals-only model drew criticism from physicians who wanted to shut down the program and argued that refills require clinical judgment around dosing, side effects, and potential drug interactions.

Conversely, Nolla points to lower costs and easier access as advantages of AI over traditional care. Nolla charges $5 per month, with prescribed medications costing $10 to $50 monthly, putting the total cost below what a dermatology visit alone can cost for some people. Nolla’s AI could also reduce wait times for physician appointments and the burden of commuting to a medical office, the company noted. At the same time, the acne treatments that Nolla’s AI prescribes carry lower risks than the chronic-condition medications involved in other Utah pilots.

Implications for the healthcare system: Pilots like those happening in Utah could help AI move further into independently delivering narrow categories of care. The phased-in approach is notable because human involvement decreases as the system demonstrates safety.

States could become testing grounds for fundamentally different definitions of medical practice. Utah’s sandbox allows models that would face regulatory barriers and bans elsewhere. Successful pilots could give other states evidence for permitting similar programs, while safety problems or louder clinician skepticism could have the opposite effect.

That shift raises questions about who is accountable when AI makes clinical decisions. Utah is already addressing that legal gray area by requiring malpractice coverage for AI-issued prescriptions and specific provisions defining Nolla’s responsibilities to patients, per Bloomberg. Those guardrails could offer an early blueprint for assigning liability when AI-driven care causes harm.

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